Administration of polyethylene glycol in critically ill patients with acute myocardial infarction: a retrospective propensity score-matched cohort study.

PURPOSE: Polyethylene glycol (PEG) is commonly administered in acute myocardial infarction (AMI) cases, though its clinical efficacy remains unclear. This study investigated whether PEG treatment enhances survival outcomes in AMI patients.

METHODS

This retrospective study analyzed data from the American Medical Information Mart for Intensive Care (MIMIC)-IV database, examining critically ill patients with AMI. The exposure was defined as PEG administration during hospitalization. The primary endpoints were 7-day and in-hospital all-cause mortality. External validation was performed using the eICU 2.0 database.

RESULTS

The study included 2422 participants before propensity score matching (PSM) and 1730 after matching. Multivariate Cox regression analysis prior to PSM revealed that PEG administration significantly lowered 7-day (HR = 0.247, 95% CI 0.179-0.341, p < 0.001) and in-hospital (HR = 0.422, 95% CI 0.347-0.512, p < 0.001) all-cause mortality. Post-PSM analysis produced consistent findings, with PEG administration linked to reduced 7-day (HR = 0.244, 95% CI 0.168-0.354, p < 0.001) and in-hospital (HR = 0.420, 95% CI 0.337-0.524, p < 0.001) mortality. Subgroup analyses indicated PEG's protective effect persisted across all clinical subgroups (all p-interaction > 0.005). External validation using Cox regression further confirmed that PEG administration significantly reduced both in-ICU (HR = 0.353, 95% CI 0.211-0.591, p < 0.001) and in-hospital (HR = 0.403, 95% CI 0.268-0.607, p < 0.001) mortality.

CONCLUSION

PEG administration improved survival outcomes in critically ill AMI patients, reducing both 7-day and in-hospital all-cause mortality.